No-Sedation in Mechanically Ventilated Chronic Obstructive Pulmonary Disease Patients; A Randomized Controlled Trial. | ||||
Minia Journal of Medical Research | ||||
Volume 31, Issue 1, January 2020, Page 12-21 PDF (658.49 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/mjmr.2022.221383 | ||||
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Authors | ||||
Mohamed F. Abdelghany1; , Atef F. Alkarn1; Mohammad G.A. Khalaf1; Wafaa A.H. Gadalla1; Emad Z. Kamel2 | ||||
1Department of Chest, Faculty of Medicine, Assiut University, Egypt | ||||
2Department of Anesthesia and Critical Care, Faculty of Medicine, Assiut University, Egypt | ||||
Abstract | ||||
Purpose: To compare no-sedation versus daily interruption of sedation (DIS) in COPD patients receiving mechanical ventilation upon the ventilator-free days. Martials and methods: Patients were randomly assigned to either DIS (n=50) or no-sedation (n=47) (intervention group). Patients failed to be managed by no-sedation strategy (n=9, 19.1%) were shifted to DIS, but analyzed in their parent group (intention to treat principle). Ventilator-free days was the primary outcome measure. Secondary outcome measures included: length of stay in the hospital and in intensive care unit (ICU), the incidence of ventilator-associated pneumonia (VAP), and weaning process (simple, difficult or prolonged). Nurse workload was assessed by the visual analogue scale (VAS). Results: no significant difference was found in ventilator-free days between DIS and no-sedation (mean 19.9 vs. 21.5 days, P=0.6). As well, we found no significant difference in length of ICU stay (P=0.7) and hospital stay (P=0.4). There was no significant difference in the incidence of VAP (P=1.0) nor in the weaning process (simple, difficult or prolonged) (P=0.328) between the two groups. The no-sedation group showed a higher nurse workload in comparison to the DIS group. (4.38 vs. 5.69, P<0.001). Conclusions: No-sedation protocol can be used safely in COPD patients with respiratory failure, but with no influence upon the ventilator-free days. | ||||
Keywords | ||||
COPD; Sedation; Mechanical ventilation | ||||
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